Pediatric emergency care
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Pediatric emergency care · Oct 2023
Impact on Emergency Department Interventions After Implementing a Guideline Based on the Pediatric Emergency Care Applied Research Network Prediction Rule for Identifying Low-Risk Febrile Infants 29 to 60 Days Old.
The Pediatric Emergency Care Applied Research Network (PECARN) prediction rule identifies febrile infants at low risk for serious bacterial infection (SBI). However, its impact on avoidable interventions in the emergency department remains unknown. ⋯ After implementation of a guideline based on the PECARN prediction rule, we observed a reduction of LPs and antibiotics in low-risk infants. Overall, a decrease in LPs was observed, whereas antibiotic use and admissions remained unchanged.
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Pediatric emergency care · Oct 2023
Case ReportsSuccessful Outcome of Manual Testicular Detorsion Using Point-of-Care Ultrasound Guidance: A Clinical Experience.
Testicular torsion is a surgical emergency. It obstructs the blood supply to the testes, leading to testicular ischemia and necrosis. It presents with a sudden onset of severe unilateral testicular pain associated with nausea/vomiting, swollen scrotum, and high-riding testicles with an absent cremasteric reflex and negative Prehn sign. ⋯ However, manual detorsion may fail because of patient discomfort, incomplete torsion, and rotation of the testicle in a less common direction. We report a case demonstrating ultrasound-guided detorsion in a 14-year-old boy with right testicular torsion. The present case highlights the importance of incorporating ultrasound guidance into manual detorsion, which can improve the success rate of the procedure.
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Pediatric emergency care · Oct 2023
Evaluation of Physicians' Knowledge About Honey/Sucralfate Treatments in Children With Button Battery Ingestion.
Ingestion of button batteries (BBs) causes serious mortality and morbidity. We aimed to evaluate the knowledge level of physicians working in pediatric emergency departments about the updated guidelines for BB ingestion and whether they used honey and sucralfate, which have proven positive effects in preventing mucosal damage, in their daily practice. ⋯ It was determined that the physicians who managed pediatric battery swallowing cases had deficiencies in their treatment approaches, they had no protocol in their institutions, and the use of mucosal damage mitigation and neutralization treatments, such as honey and sucralfate, was insufficient.
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Pediatric emergency care · Oct 2023
Early Diagnosis of Acute Myocarditis or Dilated Cardiomyopathy in Children Younger Than 2 Years.
Diagnosis of acute myocarditis or dilated cardiomyopathy (DCM) on initial presentation is difficult in children younger than 2 years because most present with complaints suggestive of a respiratory infection. The objective of this study is to determine whether signs, symptoms, and diagnostic studies excluding those of heart failure, done routinely in the emergency department could distinguish children younger than 2 years with acute myocarditis or DCM from those with respiratory illnesses. ⋯ Children younger than 2 years presenting to the emergency department with tachycardia and no fever, metabolic acidosis, and a high oxygen saturation should be investigated for acute myocarditis or DCM.
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Pediatric emergency care · Oct 2023
Observational StudyPediatric Rattlesnake Envenomations Treated With Crotalidae Equine Immune F(Ab')₂ Antivenom: A 3-Year Retrospective Observational Analysis.
Rattlesnake envenomations are uncommon, and the majority occur in adults. Although Crotalidae equine immune F(ab') 2 antivenom (F(ab') 2 AV; trade name ANAVIP) was introduced in 2018, no pediatric specific studies of F(ab') 2 AV have been reported to date. The objective of this study was to evaluate the clinical performance and adverse effects of F(ab') 2 AV in children. ⋯ Although limited by small sample size and postdischarge follow-up, F(ab') 2 AV was well tolerated in our series of pediatric patients, consistent with prior studies of all age groups.